PANOLA COUNTY FIRST RESPONDERS MEMORIAL FUNDRAISER

Panola County First Responders Memorial Fundraiser

In remembrance of the first responder heroes who made the ultimate sacrifice on September 11, 2001 - and in honor of the brave men and women who continue to serve and protect our communities today - a local effort is underway to establish a Panola County First Responders Memorial.

Spearheaded by Billy Broome, this project will create a lasting place of honor and remembrance dedicated to the firefighters, law enforcement officers, emergency medical personnel, dispatchers, and other first responders whose courage, service, and sacrifice deserve to be recognized for generations to come.

You can help make this memorial a reality by purchasing a commemorative T-shirt or hat.

T-shirts are $25 each and are available in red, white, or navy blue, with all adult sizes available.

Khaki hats are $20 each.

Proceeds from these sales will benefit the Panola County First Responders Memorial project.

ONE TSHIRT ORDER PER FORM. (Must submit a form for each shirt.)

You can order multiple hats in one form.

The Polka Dot Dane is handling the fund collecting, order processing + creation of the gear. Please contact the store for questions at 662-292-6661.

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

T-shirts are $25 each. Please submit one order form per T-shirt. If you would like to purchase more than one shirt, simply complete a new order form for each additional shirt.

First Responder Personalization - If you are a first responder and would like additional printing or personalization added to your shirt—such as your name, department, title, or other wording on the sleeve—please contact Beth Cabrera at Polka Dot Dane directly to discuss available options and any additional costs.

Polka Dot Dane | 117 Public Square | Batesville, MS | 662-292-6661

Please contact Beth in person at the store or by phone to arrange any personalization.

SHIRT COLOR

TSHIRT SIZE

HAT ORDER ($20 each)

Total

How will you be paying?

You must pay for this order in your payment app, not through this form.

Be sure to pay what is in the "TOTAL" line above, or if you are paying for multiple orders, please be sure to total them correctly.

Your order is not complete until your payment is received.

You will be contacted by email when your order is complete.

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FUNDRAISER ACCOUNTABILITY

Proceeds from this fundraiser are designated to support the development of the Panola County First Responders Memorial. Funds raised will be used toward expenses associated with the planning, construction, installation, and completion of the memorial project.

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THANK YOU FOR YOUR SUPPORT!
We Remember. We Honor. We Will Never Forget.